高频超声诊断小儿肠系膜淋巴结炎与急性阑尾炎的临床价值

Clinical Value of High Frequency Ultrasonography in the Diagnosis of Mesenteric Lymphadenitis and Acute Appendicitis in Children

目的探讨高频超声诊断小儿肠系膜淋巴结炎与急性阑尾炎的临床价值,为高频超声诊断小儿肠系膜淋巴结炎与急性阑尾炎的临床应用提供理论依据。方法选取2014年1月—2016年8月在医院接受治疗的60例肠系膜淋巴结炎患儿和32例急性阑尾炎患儿作为此次研究对象,患儿入院后给予其高频超声进行诊断,分析比较肠系膜淋巴结炎和急性阑尾炎患儿的临床指标情况、超声诊断的准确性情况。结果肠系膜淋巴结炎和急性阑尾炎患儿的临床指标为恶心呕吐、厌食、转移性右下腹痛、右下腹压痛、反跳痛、腹部肌紧张、白细胞计数和中性粒细胞分数,肠系膜淋巴结炎分别为27例、29例、6例、18例、11例、4例、(10.7±4.0)×109/L和(65.1±19.5)%,急性阑尾炎分别为23例、21例、15例、25例、25例、8例、(14.8±4.4)×109/L和(75.3±19.0)%;两种疾病相比较差异有统计学意义(P<0.05);肠系膜淋巴结炎敏感度为89.7%,特异度为90.6%,阳性预测值为86.8%,阴性预测值为92.8%,阳性似然比为9.8,阴性似然比为0.1;急性阑尾炎敏感度为90.6%,特异度为89.7%,阳性预测值为92.8%,阴性预测值为86.8%,阳性似然比为9.0,阴性似然比为0.1。结论高频超声诊断小儿肠系膜淋巴结炎与急性阑尾炎的临床价值显著,是临床检查过程中的首选方法。

Objective To investigate the clinical value of high-frequency ultrasonography in the diagnosis of mesenteric lymphadenitis and acute appendicitis in children,and to provide a theoretical basis for the clinical application of high frequency ultrasound in the diagnosis of mesenteric lymphadenitis and acute appendicitis in children.Methods Sixty children with mesenteric lymphadenitis and32 children with acute appendicitis who were treated in our hospital from January 2014 to August 2016 were selected as the subjects.The patients were diagnosed by high frequency ultrasonography after admission.To compare the clinical indexes of children with mesenteric lymphadenitis and acute appendicitis,and the accuracy of ultrasonic diagnosis.Results The clinical indexes of children with mesenteric lymphadenitis and acute appendicitis were nausea and vomiting,anorexia,metastatic right lower abdominal pain,right lower quadrant tenderness,rebound tenderness,abdominal muscle tension,white blood cell count and neutrophil fraction,mesenteric lymphadenitis（11.7±4.0）×109/L and（65.1 ± 19.5）% in acute appendicitis were 23 cases,21 cases,15 cases,25 cases respectively（14.8±4.4）×109/L and（75.3 ± 19.0）%,respectively.There was a significant difference between the two diseases（P 〈0.05）.The sensitivity of mesenteric lymphadenitis was The positive predictive value was 92.8%,the positive likelihood ratio was 9.8,the negativelikelihood ratio was 0.1;the sensitivity of acute appendicitis was 90.6%,the specificity was 89.7%,the specificity was 90.6%,the positive predictive value was 86.8%,The positive predictive value was 92.8%,the negative predictive value was 86.8%,the positive likelihood ratio was 9.0,and the negative likelihood ratio was 0.1.Conclusion High frequency ultrasound diagnosis of mesenteric lym-phadenitis and acute appendicitis in children with clinically significant value,is the preferred method of clinical examination process.